Giardia duodenalis Assemblages Associated with Diarrhea in Children in South India Identified by PCR-RFLP

Sitara S. R. Ajjampur Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Premi Sankaran Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Arun Kannan Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Kirthi Sathyakumar Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Rajiv Sarkar Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Beryl P. Gladstone Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Gagandeep Kang Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Giardial diarrhea in a birth cohort of 452 children in an urban slum in South India was characterized. Of the 155 episodes that occurred in 99 children, 73% were acute diarrhea. Children with better educated mothers and a toilet at home had lower odds of acquiring giardial diarrhea, whereas low socioeconomic status and drinking municipal water were associated with greater risk. Children with co-infections tended to have a slightly longer duration of diarrhea (P = 0.061) and showed significantly more wasting after an episode than children with diarrhea resulting from Giardia alone (P = 0.032). Among the 99 cases, 50 diarrheal and 51 asymptomatic Giardia positive samples were genotyped by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) at the triose phosphate isomerase gene. Assemblage B was predominant both in giardial diarrhea (80%) and asymptomatic giardiasis (94%). Children with Assemblage A subgroup-II alone or dual infections with both assemblage A and B had diarrhea more frequently (P = 0.07).

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